The Gluten-Free Homemaker

Celiac disease, gluten intolerance, and wheat allergy are all conditions that lead people to eat a gluten-free diet. While the diet is the same (mostly), there are differences among the conditions.

Celiac disease is an autoimmune disease. When gluten is ingested, the immune system triggers an attack on the person's own body, specifically the small intestine. The attack causes damage to the villi lining the small intestine. The damage can be healed after switching to a gluten-free diet. Celiac disease cannot be outgrown, and a person diagnosed with it should follow a gluten-free diet for life.

Gluten intolerance does not involve the immune system and does not cause damage to the body. It is, however, very unpleasant to live with an intolerance because the digestive system is intolerant to the particular food, causing gastrointestinal symptoms.

Any allergy, including wheat allergy, is an immune response. While the body sees the trigger as a danger and produces unwanted symptoms, it does not attack itself and damage tissue as in celiac disease. That doesn't mean allergies are not dangerous. They are certainly life threatening in people who react by going into anaphylaxic shock. Allergies are not necessarily life long. Many children outgrow food allergies.

I think it is unfortunate that many people today are going on a gluten-free diet without being tested for celiac disease. I understand their desire to do anything that will help them feel better because I have been there myself. The problem is that tests for celiac disease will not be accurate if a person has been gluten-free for a while. Going back on gluten is hard. Thankfully, I only had to do it for two weeks because I had not been gluten-free for long.

If a person has celiac disease, a formal diagnosis can be beneficial for several reasons. Here are a few of those reasons with the first one, I believe, being the most important.

• The gluten-free diet is difficult to follow and knowing whether it is necessary can make a big difference in how well a person adhers to the diet. At first, as I said, a person is willing to do anything to feel better, but it gets more challenging as time goes on and they get back to feeling normal. Because of the autoimmune response, it's important for a celiac to be very strict with his/her diet. Some people (like me) are very sensitive to gluten and have unpleasant reactions to the tiniest bit. Other people don't have outward symptoms when they consume gluten, but an autoimmune response is still going on inside and intestinal damage is being done.
• A formal diagnosis can help family members (even extended family) to take the disease into consideration and get tested.
• Medical professionals may take people more seriously when they have a formal diagnosis. A diagnosis is definitely required in order to participate in any clinical trials. I have done this and would do it again despite the fact that I got sick. It was worth it for the scientific contribution it made that will hopefully benefit all celiacs.
• Friends and family may take you more seriously, be more understanding, and be more willing to accomodate you. Personally, I have a great bunch of friends and family who go out of their way to prepare food that I can eat. Not that they wouldn't be great about it if I didn't have a formal diagnosis, but it helps them understand the importance of being so careful.

I'd be interested in hearing your thoughts and questions on any of these topics. If you eat gluten free, are you a celiac, intolerant, allergic or unsure?

Labels: celiac disease